scholarly journals Reducing sitter use in acute medicine while maintaining safety and quality

2018 ◽  
Vol 9 (2) ◽  
pp. 61
Author(s):  
Delois Long ◽  
Janice Dennis
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Assessment Tool ◽  
Medical Center ◽  
Intervention Group ◽  
Post Intervention ◽  
Acute Medicine ◽  
Quality Of Patient Care ◽  
Interventional Group

Background and objective: Sitters are commonplace in acute care facilities throughout the country. Sitters are used to provide close observations and ensure safety for patients who are at risk for falls. These patients suffer from cognitive impairment, inability to follow instructions, and causing harm to themselves or others. The literature shows that one requirement for an effective sitter process is the use of an assessment tool. Sitter usage at the Louis Stokes Cleveland VA Medical Center (LSCVAMC) has escalated to the point that sitters are causing an overall shortage of nursing staff.  This shortage causes excessive overtime, staff burnout, and reduces the quality of patient care provided to non-sitter patients. The purpose of this case-control descriptive pilot study was to reduce sitter usage on an inpatient acute medicine unit, by implementing the Patient Attendant Assessment Tool (PAAT), without reducing patient safety and quality of patient care. The PAAT was developed and utilized by a Midwest hospital for data collection and to assess the need for sitters.Methods: Patients were placed into the Pre- and Post-implementation cohorts, according to the order of their admission. Pre-interventional data was collected from the study group, using the Sitter Justification Form, the 24-hour nursing report and the electronic medical record. The intervention consisted of staff education on the use of a new tool, the PAAT. Following implementation of the tool, the data was collected and analyzed using the SPSS 20 for windows (SPSS.INC), over an 8-month period.Results and conclusions: Sitter usage was reduced without reducing patient safety or quality of care, with the implementation of the PAAT. Among individuals having at least one sitter day, patients in the post intervention group, were less likely to have as many sitter shifts (n = 343, 58.0%) as compared to patients in the Pre-interventional group (n = 451, 75.9%) (Chi Square = 42.88; df = 1, p < .001). As can be seen, there was a significant decrease in the number of sitter shifts after the implementation of the PAAT, as compared to the pre-interventional group. There was a slight increase in the quality of patient care.

58. Stories - Structured operative reporting in enteric surgerys

2007 ◽  
Vol 30 (4) ◽  
pp. 60
Author(s):  
L. M. Gillman ◽  
A. Vergis ◽  
J. Park ◽  
S. Minor ◽  
M. Taylor
Keyword(s):  
Subgroup Analysis ◽  
Assessment Tool ◽  
Intervention Group ◽  
Senior Resident ◽  
Comfort Level ◽  
Rank Test ◽  
Junior Resident ◽  
Post Intervention ◽  
Operative Note

The purpose of this study was to determine whether the introduction of a Standardized Operative Dictation Template improved the quality of resident dictation. General surgery residents (N = 20) from the University of Manitoba participated in the study. All residents were shown a standardized surgical procedure video and then asked to dictate an operative report. Residents were randomized with the intervention group receiving the Operative Dictation Template. Three months later, all residents were retested. Resident comfort level with dictation and satisfaction with the template was evaluated with a questionnaire. Dictations were evaluated by two blinded independent reviewers using the previously validated SAFE-OR assessment tool. This tool consists of a Structured Assessment Form (SAF) scored out of 45 and a Global Quality Ratings Scale (GQRS) out of 36. Pre and post scores were analyzed using a two-tailed Wilcoxon signed rank test. Subjective comfort level with dictation, as measured by responses on a five point Likert scale, improved significantly in the intervention group (p=0.02). In addition, 90% of residents in the intervention group subjectively reported their dictations improved because of the template. There was no overall difference in the quality of dictation in the intervention group pre and post intervention as measured by the SAF (28.6 vs. 30.0; p=0.36) and GQRS (21.7 vs. 21.8, p=0.96). However, junior resident subgroup analysis revealed statistically significant improvement in the intervention on both the SAF (23.2 vs. 28.3; p=0.02) and GQRS (17.1 vs. 20.4; p=0.02). Senior resident subgroup analysis showed no difference in the intervention group on either the SAF (36.8 vs. 32.4; p=0.07) and GQRS (28.5 vs. 23.9; p=0.07). The Operative Dictation Template can result in a significant improvement in resident comfort level with dictation and has the potential to improve the quality of junior resident dictations. Eichholz AC, Van Voorhis BJ, Sorosky JI, Smith BJ, Sood AK. Operative note dictation: should it be taught routinely in residency programs? Obstetrics and Gynecology 2004; 103:342-6. Menzin AW, Spitzer M. Teaching operative dictation. A survey of obstetrics/gynecology residency program directors. Journal of Reproductive Medicine 2003; 48:850-2. Moore RA. The dictated operative note: important but is it being taught? Journal of the American College of Surgeons 2000; 190:639-40.

scholarly journals “Pixie dust”

2019 ◽  
Vol 33 (5) ◽  
pp. 635-646
Author(s):  
Susan Brandis ◽  
Stephanie Schleimer ◽  
John Rice
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Health Service ◽  
Patient Care ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Content Type ◽  
Quality Of Patient Care

Purpose Creating a culture of patient safety and developing a skilled workforce are major challenges for health managers. However, there is limited information to guide managers as to how patient safety culture can be improved. The purpose of this paper is to explore the concept of reflexivity and develop a model for magnifying the effect of patient safety culture and demonstrating a link to improved perceptions of quality of care. Design/methodology/approach This research employed a correlational case study design with empirical hypothesis testing of quantitative scores derived from validated survey items. Staff perceptions of patient safety, reflexivity and quality of patient care were obtained via a survey in 2015 and analysed using inferential statistics. The final sample included 227 health service staff from clinical and non-clinical designations working in a large Australian tertiary hospital and health service delivering acute and sub-acute health care. Findings Both patient safety culture and reflexivity are positively correlated with perceived quality of patient care at the p<0.01 level. The moderating role of reflexivity on the relationship between patient safety culture and quality of care outcomes was significant and positive at the p<0.005 level. Practical implications Improving reflexivity in a health workforce positively moderates the effect of patient safety culture on perceptions of patient quality of care. The role of reflexivity therefore has implications for future pre-professional curriculum content and post-graduate licencing and registration requirements. Originality/value Much has been published on reflection. This paper considers the role of reflexivity, a much less understood but equally important construct in the field of patient safety.

scholarly journals The relationship between the nurses’ work environment and the quality and safe nursing care: Slovenian study using the RN4CAST questionnaire

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261466
Author(s):  
Martina Brešan ◽  
Vanja Erčulj ◽  
Jaro Lajovic ◽  
Mirjam Ravljen ◽  
Walter Sermeus ◽  
...  
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Work Environment ◽  
Nursing Care ◽  
Quantitative Research ◽  
Influential Factors ◽  
Quality Of Patient Care ◽  
The University ◽  
Clinical Departments

Introduction The safety and quality of patient care are basic guidelines in finding new and improved solutions in nursing. Important and influential factors shape the nurses’ work environment in hospitals. Purpose With the study, we intended to investigate whether the perception of nurses’ work environment is related to the safety culture and the quality of patient care and whether it differs according to nurses’ level of education. Methods of work The study with a quantitative research method was conducted at the six clinical departments of the University Medical Centre, Ljubljana in 2019. We used a survey questionnaire from the European survey Nurse forecasting in Europe (RN4CAST). Results 270 nurses were included in the study. The response rate was 54%. The study confirmed that there is a correlation between the assessment of the nurses’ work environment and the general assessment of patient safety (r = 0.36; p <0.001), the general assessment of the quality of nursing care (r = 0.32; p <0.001), the confidence in patient self-care at discharge (r = 0.29; p <0.001) and the quality of patient care in the previous year (r = 0.27; p = 0.001). The results showed frequent verbal abuse of nurses, in 44.9% by patients and their relatives and in 35.4% by staff. Graduate nurses rated the work environment more negatively than healthcare technicians (p = 0.003). Discussion and conclusion We confirmed the correlation between the assessment of nurses’ work environment and patient safety and the quality of health care, and that employees’ education influences the assessment and perception of the work environment.

494 Streamlining the Minor Operations Process - The Effect of Better Documentation

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Schrire ◽  
C Estela
Keyword(s):  
Patient Care ◽  
Plastic Surgery ◽  
Patient Experience ◽  
Patient Flow ◽  
Vital Part ◽  
Rapid Turnover ◽  
Quality Of Patient Care ◽  
New Form ◽  
Minor Operations

Abstract Introduction Plastic Surgery Minor Operations is a fast paced, rapid turnover operative environment. It is reliant on effective communication, accurate surgery, and time efficiency. It was noticed in our department that there was confusion regarding booking and operative intentions leading to delays in surgery and over-running lists. This was worsening patient experience and leading to delays in patient care. Method In response to the delays and confusion in booking, a new booking form was created, so all patients have a standardised booking containing the necessary information. This form was disseminated across all the booking clinics and formed a vital part of the pre-operative check in process. Results The audit was carried out at the time of introduction, and then re-audited a year later to see if the form has improved care for patients. Results showed that with the new booking form, people were not having to cancel or rearrange patients. Patient booking forms were sufficient, and a copy of the clinic letter no longer required for the operation to proceed or for clarity. It was noted that more senior advice was sought. Conclusions The new form has improved patient flow and quality of patient care, whilst streamlining the booking process.

scholarly journals Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

2020 ◽  
Vol 93 (6) ◽  
pp. 343-350
Author(s):  
Molly O. Regelmann ◽  
Rushika Conroy ◽  
Evgenia Gourgari ◽  
Anshu Gupta ◽  
Ines Guttmann-Bauman ◽  
...  
Keyword(s):  
Patient Care ◽  
Care Patient ◽  
The Novel ◽  
Patient Privacy ◽  
Pediatric Endocrinology ◽  
Quality Of Patient Care ◽  
Care Outcomes ◽  
Novel Coronavirus ◽  
The Impact

<b><i>Background:</i></b> Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. <b><i>Summary:</i></b> The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. <b><i>Key Messages:</i></b> With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

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